Assistive Technology: Improving Quality of Life Through a First-Principles Approach

Assistive Technology (AT) is fundamentally about improving quality of life. While arguments are often made around transferable skills and independence, the heart of AT is simpler, yet deeper—it's about facilitating intentions and enhancing the everyday experiences of disabled individuals.

Why We Do It: Beyond Independence

There's a common assumption in AT that the ultimate goal is independence—often measured against societal expectations set by non-disabled norms. However, we need to re-examine this assumption, returning to first principles to understand what genuinely enhances quality of life. Life isn't just about independence; it's fundamentally about interdependence—relying on strong, reliable networks of support, a concept especially vital for our caseload of clients.

Beth Moulam, a renowned advocate, clearly illustrated this point in her training session on advocacy. Her support team's goals often targeted independence, such as enabling her, a person with quadriplegic cerebral palsy, to feed herself, despite the immense cost to her mental and physical fatigue. Recognising what was most important to her and having developed the skills and confidence to advocate for herself, she instructed her support team to “just feed me!”. Beth preferred to conserve her energy for activities she genuinely valued and chose interdependence over the energy-expensive notion of independence.

Low-Tech, or No-Tech, is often the best option

Despite working in a technology consultancy, I often find myself advocating for no-tech solutions when we unpick what we're actually trying to achieve. For example, the desire for learners to complete exams independently can usually miss the point. When we boil it down to first principles and ask ourselves, "What are we genuinely measuring?" it becomes apparent that when using tech for independent working, the exam often becomes a measure of fatigue levels rather than an assessment of knowledge and understanding. For the majority of our caseload with Cerebral Palsy, the energy expended to sit upright, let alone finely manipulate a keyboard or joystick to write, is vastly more than for their non-disabled peers. Using no-tech solutions, like a scribe, may allow someone to truly have their knowledge and understanding assessed, rather than measuring how much they could write before their energy levels are depleted.

The Misplaced Focus on Transferable Skills

The "transferable skills" argument also often misses the mark. While yes, AT can, and does, build transferable skills, that should be a fortunate byproduct rather than the initial purpose. For example, we don’t need to excuse assistive gaming as a transferable skill to control a device for a more acceptable educational purpose. If an individual’s quality of life is improved, that’s reason enough to invest time and resources into a solely fun outcome. Our experience is that motivation is 90% of the journey to success, so let's just play—without worrying about how to justify it.

The Golden Bubble of Joy

In our practice, we’ve labelled the ideal incubator for AT the "Golden Bubble of Joy"— defined as a 'supportive network of interdependencies confidently enhancing someone's quality of life'. In other words, AT thrives within a great team. To achieve this, we work towards making ourselves redundant—equipping families, carers, and educators to maintain and develop AT solutions themselves. Our mission is to inspire people to embrace and drive what can be made possible through the use of technology—our measure of success is not ‘can the person do the task’ but is their team equipped to support them to achieve their intentions, now and in the future.

"Can Grandma Turn It On?"

A guiding question throughout my AT career remains simple: "Can Grandma turn it on?" This question embodies usability, accessibility, and sustainability. AT interventions should be intuitive and manageable within everyday life. Technology evolves rapidly; devices we use today will all be outdated within four years. Embracing this ever-evolving landscape is essential but only works if the support team are empowered to use AT and, more importantly, have bought into the positive benefits it can bring. We don’t teach people just how to use a tool, but instead, encourage them to wholeheartedly embrace the concept that AT improves quality of life. Developing 'AT buy-in' ensures teams can adapt to whatever new technologies and challenges come along.

Culture Shift: Embracing the Social Model

Our consultancy strongly advocates for the social model of disability: we adapt the environment, not the individual. This model requires us to view disability through a lens of societal inclusion and responsibility. It's not a "dump-and-run" approach to AT—we embed ourselves in the support network, building competence, resilience, and confidence.

Ultimately, by rethinking our interventions, decisions and actions using a first-principles approach, we uncover that good AT is not about the tech; it’s about the people who use it.